SOCIAL WORKERS AS INFORMAL LEGAL INTERMEDIARIES: RESOLVING CONFLICTING RIGHTS IN NURSING HOMES

Abstract Conflicting rights arise often in nursing homes among residents, staff, and family. Nursing home social workers sit at a unique nexus of these rights, given their macro, mezzo, and micro-level training. This study employs a multi-method qualitative design with semi-structured staff interviews (n=90) (direct care, mid-level professional, top management), content analysis of long-term care facility policies (n=376), and ethnographic observation of two facilities (n=8 months) for a multi-layered cross-comparative in-depth case study. While social workers represented only a very small number of the overall nursing home workforce, data revealed the overwhelming reliance on social workers to resolve conflicting rights that arose among residents, staff, and family. Certified nursing assistants, nurses, directors, and administrators regularly deferred to social workers via written policies and unwritten practices to resolve a variety of issues, including discrimination concerns by staff, residents, or family, concerns about quality of care and workforce shortage, and concerns about conflicting rights to resident autonomy, dignity, medical decision-making, and safety (e.g., bed rails). Staff at all levels and professions described the emotional labor and unique professional experience that these conflicts required and felt ill-equipped to resolve these issues. While social workers resolved most of these conflicts, they, too, reported feeling ill-prepared for this role and worried about out-of-scope practice. Ultimately, they relied on their social work training in systems-level change, case management, and interpersonal communication to resolve conflicting rights. This presentation will discuss social worker challenges as informal legal intermediaries and opportunities for better support and training.

providing support to residents and families at end of life, and resolving conflicts between residents, families, and staff.In their roles, they often need to balance conflicting priorities and determine whose rights or needs should take priority.Little is known about how these conflicts affect the social workers in their jobs.This presentation will report the results of a content analysis of the answers to two open ended questions, "What do you like about your job?" and "What would you change about your job?" in a nationally representative sample of nursing home social service directors.The results illustrate directors' views of what they value in terms of helping residents, families, and staff navigate change, difficult conversations, and conflicting interests.Social service directors report that their priorities are residents and their families, specifically advocating for resident needs.They also report needing to advocate for the role of social work on the interdisciplinary team.They report that family dynamics are messy, but do not discuss how they prioritize within and between residents, their family members, and nursing home staff.More research is needed to understand the decision making process that social workers employ in decision-making about priorities.Conflicting rights arise often in nursing homes among residents, staff, and family.Nursing home social workers sit at a unique nexus of these rights, given their macro, mezzo, and micro-level training.This study employs a multi-method qualitative design with semi-structured staff interviews (n=90) (direct care, mid-level professional, top management), content analysis of long-term care facility policies (n=376), and ethnographic observation of two facilities (n=8 months) for a multi-layered cross-comparative in-depth case study.While social workers represented only a very small number of the overall nursing home workforce, data revealed the overwhelming reliance on social workers to resolve conflicting rights that arose among residents, staff, and family.Certified nursing assistants, nurses, directors, and administrators regularly deferred to social workers via written policies and unwritten practices to resolve a variety of issues, including discrimination concerns by staff, residents, or family, concerns about quality of care and workforce shortage, and concerns about conflicting rights to resident autonomy, dignity, medical decision-making, and safety (e.g., bed rails).Staff at all levels and professions described the emotional labor and unique professional experience that these conflicts required and felt ill-equipped to resolve these issues.While social workers resolved most of these conflicts, they, too, reported feeling ill-prepared for this role and worried about out-of-scope practice.Ultimately, they relied on their social work training in systems-level change, case management, and interpersonal communication to resolve conflicting rights.This presentation will discuss social worker challenges as informal legal intermediaries and opportunities for better support and training.

COGNITIVE ASPECTS OF MANAGING STRESS AND UNWANTED EMOTION SUCCESSFULLY IN OLD AGE Chair: Tammy English
The ability to cope with stressors and manage unwanted emotion is central to health-related outcomes across adulthood.Prominent models of adult development suggest there may be age-related shifts in motivational strivings and accumulated knowledge that help support emotional well-being in old age.At the same time, older adults have cognitive and physical vulnerabilities that may offset some of these strengths.This session will showcase new work leveraging experimental and experiencing sampling methods to examine how people of varying ages and resource levels manage their emotions.These studies provide new insights into how older adults respond to stressors and adverse stimuli in controlled settings and daily life contexts.The first talk centers on how individuals are negatively impacted by cognitive stressors regardless of age, but older adults show more resilience than younger adults after stressor exposure.The second talk focuses on how a cognitive process known as affective labeling (or naming one's emotions) can create emotion regulation difficulties, especially in old age.The third talk examines emotion regulation success and the benefits of instructional support for cognitively normal older adults compared to those with mild cognitive impairment (MCI).The fourth talk extends this work by tracking emotion regulation motives in daily life, showing that cognitively diverse older adults report fewer attempts to manage their emotions, but similar reasons for doing so, compared to relatively younger adults.Together these presentations delineate age-related similarity and differences in emotion regulation, highlighting avenues through which coping capacity may be maintained and improve in late life.
Abstract citation ID: igad104.0110Age is associated with declines in cognitive resources viewed as important for emotion regulation, and older adults with mild cognitive impairment (MCI) are expected to experience difficulty with emotion regulation.The present study examines how providing support through emotion regulation instructions might contribute to improved emotional well-being using different indices of emotion regulation success.Young adults (age 21-34, n = 66) and older adults with MCI (age 70-84, n = 60) and cognitively normal older adults (age 70-84, n = 90) completed a laboratory task in which they viewed high-arousal negative emotional film clips under instructions to regulate prohdonically (a) using any emotion regulation strategy, and (b) using an instructed strategy based on condition: distraction or reappraisal.We examined three indices of emotion regulation success: self-perceived emotion regulation success, self-reported experience of the target emotion, and behaviorally-coded expression of the target emotion.Overall, there were no group differences in experience or expression, but older adults with MCI perceived that they regulated with less success compared with younger adults and cognitively normal older adults.Younger adults reported experiencing less of the target negative emotion on instructed versus self-selected strategy trials, whereas older adults with MCI expressed less of the target negative emotion on instructed versus self-selected strategy trials.Findings suggest that younger adults and older adults with MCI might benefit more from support with regulating emotions compared with cognitively normal adults, who are theorized to have expertise in this domain.

EMOTION REGULATION SUCCESS IN A LABORATORY TASK IN YOUNG ADULTS AND COGNITIVELY DIVERSE OLDER ADULTS
Abstract citation ID: igad104.0111

HOW OFTEN AND WHY DO PEOPLE MANAGE THEIR EMOTIONS?: EMOTION REGULATION IN HEALTHY AGING AND MILD COGNITIVE IMPAIRMENT
Tabea Springstein, and Tammy English, Washington University in St. Louis, St. Louis, Missouri, United States Prominent theories of adult development suggest that individuals increasingly prioritize emotional goals and social relationships as they grow older.Accordingly, older adults are expected to invest more in maintaining their emotional well-being compared to younger adults.Prior work suggests that older adults may accomplish this goal by structuring their lives in ways that reduce the need to manage unwanted emotion.We tested the hypotheses that (1) older adults regulate their emotions less often in daily life compared to younger adults, and (2) when emotion regulation occurs, older adults are relatively more motivated by pro-hedonic and social concerns.Using experience sampling (7x/day for 9 days), we assessed whether emotion regulation frequency and motives differ between younger adults (N = 70), cognitively normal older adults (N = 88), and older adults with mild cognitive impairment (MCI; N = 60).We found that older adults with and without MCI regulated their emotions less frequently than younger adults, even when controlling for mean levels of positive and negative emotional experience.However, there were largely no group differences in emotion regulation motives (i.e., why people wanted to manage their emotions).Future work is needed to explore how age-related differences in life contexts might contribute to less need for emotion regulation in relatively older adults.Less frequent regulation could be beneficial in terms of helping older adults preserve their more limited cognitive resources.The findings regarding motives add to growing research on aging which suggest maintenance or similarity in many emotion regulation processes across adulthood.Prior research has shown that naming one's emotions before regulation has a detrimental effect on regulation success (Nook et al., 2020).These researchers argued this effect was due to the affect crystallization that occurs after naming an emotion, which in turn makes it harder to modify or regulate Abstract citation ID: igad104.0112EFFECTOF EMOTION NAMING ON EMOTION REGULATION IN YOUNGER AND OLDER ADULTSHannah Wolfe, and Derek Isaacowitz, Northeastern University, Boston, Massachusetts, United States